gms | German Medical Science

14. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

7. - 9. Oktober 2015, Berlin

Spatial distribution of demand and supply for dental services in Northern Germany: a longitudinal comparison

Meeting Abstract

  • Ralf Jäger - Ernst-Moritz Arndt Universität Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Neeltje van den Berg - Ernst-Moritz-Arndt Universität Greifswald, Institut für Community Medicine, Greifswald, Deutschland
  • Rainer Jordan - Institut der deutschen Zahnärzte, Köln, Deutschland
  • Wolfgang Hoffmann - Ernst-Moritz-Arndt Universität Greifswald, Institut für Community Medicine, Greifwald, Deutschland
  • Falk Schwendicke - Charité Berlin, Zahnerhaltung und Präventivzahnmedizin, Berlin, Deutschland

14. Deutscher Kongress für Versorgungsforschung. Berlin, 07.-09.10.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocFV34

doi: 10.3205/15dkvf048, urn:nbn:de:0183-15dkvf0488

Veröffentlicht: 22. September 2015

© 2015 Jäger et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Background: Dental services planning needs to account for the spatial distribution of oral health/morbidity, the related demand, and changes in the local dental workforce, i.e. the supply with dental services.

Objectives: We aimed at assessing changes in demand, supply and the ratio of demand and supply between 2001-2011 in Northern Germany, and to identify spatial predictors for potential under- and over-servicing.

Methods: By linking working time of dentists and claim data to oral morbidity in different age groups, a demand model for dental services was constructed. This model was applied to the zip code area (ZCA) level population data of 2001 and 2011 in the federal state of Mecklenburg-Vorpommern in northern Germany. The supply with dental services was calculated using register data and reported gender-specific working time estimates. The ratio of demand and supply was evaluated using Gini-coefficients and spatial analysis. Prediction models for this ratio were assessed using generalized linear and geographically weighted regression modelling.

Results: Between 2001 and 2011, there was a significant decrease of the general population of Mecklenburg-Vorpommern (-7.0%), the annual demand of dental services (-13.1%), the dental workforce (-9.5%), and the annual supply (-12.9%). The demand-supply-ratio did not change significantly (p>0.05), but was more unequally distributed between ZCAs in 2011 than 2001 (Gini-coefficient: 44.4 versus 41.9). Few ZCAs were over-serviced, whilst many were under-serviced. Significant spatial clustering of dental practices was not observed (Moran’s I=0.18; Z=1.79, p>0.05 in 2001 and 2011). For 2001, population density significantly predicted the demand/supply ratio, this was confirmed via GWR (R²=0.59). For 2011, no variable had any statistically significant predictive value.

Discussion: A changing workforce and a demographic shift combined with a polarization of demand and supply challenges dental services planning. For Northern Germany, spatially specific dental under- and over-servicing aggravated between 2001 and 2011.

Practical implications: Spatial analyses should be standardly used for dental services planning; the established model is suitable for such analyses.